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In the quest for a so-called “heart healthiest diet,” the Mediterranean Diet has always ranked near the top. Revered for its capacity to control cholesterol and prevent heart disease, the diet that finds its origins in the regimen of the people of Crete has also shown promise when it comes to optimizing health in the entire vascular system, ranging from the prevention of cognitive decline to the management of erectile dysfunction.

More recently, a diet plan known as the Portfolio Diet has yielded similarly impressive results when it comes to heart health. The Portfolio Diet, which is rich in cholesterol-lowering foods ranging from oats to psyllium fibre, to plenty of fruits, vegetables, beans and legumes, has a demonstrated ability to reduce LDL cholesterol (the so-called “bad” one) by nearly 30 per cent — a similar effect to that of some cholesterol-lowering drugs.

So which diet is the better one for heart health? In the true spirit of compromise, researchers from St. Michael’s Hospital in Toronto took a key component of the Mediterranean Diet, the monounsaturated fat (or MUFA) content, and blended it with the rest of the key features of the Portfolio Diet. The hope was that by increasing its MUFA content, the Portfolio Diet would not only lower LDL cholesterol, but also raise levels of the so-called “good” cholesterol, known as HDL.

Why MUFA matters

Why are MUFAs, which are found in nuts, avocados, olives and olive oil, so crucial to a heart-healthy diet? There are various hypotheses, but a key one is the impact the fats have on HDL cholesterol. While elevated levels of LDL cholesterol are a well-established risk factor for heart disease, low levels of HDL are similarly concerning. HDL can be boosted through regular exercise, reducing trans fats, as well as by including moderate amounts of monounsaturated fats in the diet.

In the study, which will be published in this week’s edition of the Canadian Medical Association Journal, researchers placed 24 participants with mild to moderately high cholesterol on a diet low in saturated fats for one month. In the second month of the study, they placed the participants on a vegetarian Portfolio Diet, which also included a margarine enriched with plant sterols, compounds known for their cholesterol-lowering capacity. The researchers then modified the diets of half of the subjects by making 13 per cent of their calories come from a MUFA-rich sunflower oil (control subjects did not receive the oil).

At the end of the two months, the treatment group (those who received the extra monounsaturated fat through sunflower oil in their diet) not only saw HDL cholesterol levels increase by 12.5 per cent, but their LDL cholesterol levels by dropped by a whopping 35 per cent — even more than in the traditional Portfolio Diet. By comparison, the HDL levels of the control group (those who were on the Portfolio Diet, but without the extra MUFA) remained unchanged.

How to boost your MUFA

While the participants in the study received substantial support in implementing their heart healthy diets, anyone can benefit from implementing even a few of the key foods from both the Portfolio and Mediterranean regimens.

For example, you can add monounsaturated fats to your diet through moderate portions of olive oil (up to one tablespoon per day as part of salad dressings or cooking), avocados (up to ¼ per day on salads, as a spread on bread or wraps, or in a smoothie), almonds (up to one ounce, or 23 per day). For optimal benefits, you need to simultaneously substitute MUFA for lower quality fats or refined carbohydrates (in this particular study, participants substituted MUFA for carbs). For example, instead of a 120-calorie granola bar as a snack, try 15-20 almonds, or 10 almonds and an apple.

If MUFA isn’t your issue, you might benefit from adding more soluble, viscous fibre to your diet, such as the various fibre-rich foods used in this study. For example, instead of your usual breakfast cereal, try sprinkling ground flaxseed and mixed berries on oatmeal, or add 1/3 cup of Kellogg’s All-Bran Buds with Psyllium, or Smart Bran by Nature’s Path (both sources of cholesterol-lowering psyllium fibre) to yogourt, or even on top of your favourite cereal. And adding more beans and legumes to your diet can be easy when you toss lentils into soup, chick peas on salads, or by including a mixed bean salad with your lunch, or as a snack.

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